Caesarean rates soar as age of first-time mothers rises

Operation now used in 30% of births in Ireland – a four-fold increase since 1984

The rise in the number of Caesarean sections is mostly due to the increased safety of the operation but a 65 per cent jump in births to over-35s has also contributed. Photograph: Martin Carlsson/iStockphoto via Getty

The rise in the number of Caesarean sections is mostly due to the increased safety of the operation but a 65 per cent jump in births to over-35s has also contributed. Photograph: Martin Carlsson/iStockphoto via Getty

 

An increase in the average age of first-time mothers is one of the main factors behind soaring Caesarean section rates in Ireland, according to new research.

The proportion of births delivered by Caesarean section has grown four-fold in the past 30 years – from 7 per cent in 1984 to 13 per cent in 1993 and 30 per cent in 2014.

Mostly, this is due to the increased safety of the operation but a 65 per cent jump in births to over-35s has also contributed.

Since 1999, the average age of mothers has increased from 30 to 32 years and the proportion of births to over-35s has grown from one-fifth to one-third.

The research shows the average level of risk associated with mothers giving birth in Irish hospitals is worsening as their age profile rises.

For example, the proportion with gestational diabetes has risen 320 per cent in a decade while the occurrence of mothers with high blood pressure is up 20 per cent.

The popularity of Caesareans is growing across the OECD but Ireland’s rate is “average to high” by international standards, the research finds. The Netherlands, for example, has a rate almost 50 per cent lower than Ireland’s.

Variation

Since 1999, the difference between the units with the highest and lowest rates has increased, although the overall variation across maternity units is down.

The National Maternity Hospital at Holles Street has the lowest rate of Caesarean section, at 24 per cent, a Department of Health study published this year found. South Tipperary General and St Luke’s hospital in Kilkenny had the highest rates, at over 35 per cent. The units that had the highest rates back in 1999 have shown the biggest increase since, the latest research shows.

The research, conducted jointly by the Economic and Social Research Institute, Trinity College Dublin and University College Dublin, will be discussed at a conference in the institute on Tuesday.

Prof Michael Turner of UCD said Irish maternity units continued to deliver results that were “among the best in the world” despite challenges. “If we wish to maintain this record we will need to invest to take account of adverse trends whilst constantly striving to coordinate and improve practice in Irish maternity services.”

Although the average level of risk arising from mothers giving birth in hospitals is rising, funding and staffing levels have not kept pace with either the number of births or this risk profile.